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Home My WebLink About0316 MARINER CIRCLE - Health 3�� f�no��v� �"rc.l.� `Z�G��7 � LOCATION 40 SEWAGE PERMIT NO• VILLAGE A I N S T A L ER'S NAME i ADDRESS BUILDER 01 OWNER DATE PERMIT ISSUED DATE C0111PLIANCE ISSUED 1T �SST m J c �` D R I (Ve No. Finc............................. THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH RWRIUS-14a ...................OF..... .......................... ...................................... Appliratiou for Bispoiial Works Tomitrartion ramit Application is hereby made for a Permit to Construct A or Repair an Individual Sewage Disposal System at: .... ........ ..... ................................................................................................. Locatio;/ ress or" No. ................................................. ......... ... ... f 1 ... .......... ........... .............................................. Owner Address .. . , � W ,( ................................................................................ ..... Installer Address Type of Building Size Lot.— 1 --093------- ...Sq. feet ---- U Dwelling—No. of Bedrooms......_... Expansion Attic Garbage Grinder ') o/t------------------------- Other—Type of Building 4e _W.... No. of persons........eA................ Showers Cafeteria P-4 Other fixtures .........................t........................................................................................................................... Design Flow......... 'r ....................gallons per person per ,day. Total dall flow....- -----------------------gallons. WSeptic Tank—Liquid'capacity//AO-.gallons Lengthfen.�r///. Width.. ..... Diameter________--_-_- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 7.4 elf _..j Seepage Pit No..... /............. Diameter......Width..._............. Depth below inlet-. .... Total leaching area.. Z Other Distribution box (/ ) Dosing tank ( ) 0.7 Percolation Test Results Performed by__.;V0.,V4dk..O� ..................... ................ Date-,J... Er......... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........Lf --------- Test Pit No. 2................minutes per inch Depth of Test Pit.............._.._.. Depth to ground water.-We .................... ............................................................................................................................................................. 0 Description of Soil.............................i............. . ............................................................................................................ ...............................................*... .........:;�� U .............................................................................................................................. W ................................................................................................................................. ...................................................................... �4 U Nature of Repairs or Alterations—Answer when applicable._.......................................:...................................................... ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 1E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board,-of health. Signed..e� ................. ---4 fpl-IRP W% z,: ]Crate ;V---—---- ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:................................................................................................................ ........................................................................................................................................................................................................ Date PermitNo......................................................... Issued........................................................ Date No. . Fim................``.,........ ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Apptirtt#iun for Biupuuttl Worko Tunitrurfiun ramit Application is hereby made for a Permit to Construct (,}�) or Repair ( ) an Individual Sewage Disposal System at: .................._ .::.........---.._..------•----•--•--..._...........•• ._...._....... _..--••-----•-----------•--.........---------•--------•-------.....------......................... Location-'Address � ,! r or Lot No. A'r ............ ................ ............................................................... .................. ......_............�_....__......... -•" �',....+ ,,� �/ Owner ,r ,. Address '................................ �r.... f_s'....'°'l .. ++ ` �<f.. Itt�rflh Installer Address Type of Building Size Lot.................` c.....Sq. feet Dwelling—No. of Bedrooms...............1!� 4 ..............................Expansion Attic ( ) Garbage Grinder ( ) � Other—Type of Building ._,._____.......... ...... No. of persons........!��-................ Showers ( ) — Cafeteria fixtures ( ) dOther .----•-------------------------•---•--•---------------------------------------------------------......---------------...--•-----...---•-------------- W Design Flow...........::..............................gallons per person per day. Total daily flow__._......! ...........................gallons. WSeptic Tank—Liquid capacityAZ4..gallons Length 1`'q�/_. Width?5°.l."''._ Diameter................ Depth................ x Disposal Trench—No..................... Width_._............... Total Length.................... Total leaching area............_..sq. ft. p Seepage Pit No ............ Diameter....... Depth below inlet_•-rf' _'.___ Total leaching area..�' _._..ssq eft z Other Distribution box (/ ) Dosing tank 0-4Percolation Test Results Performed by___ 'f"'!r�� + �. :!?"? _:r''!?' _______________ _ Date__ �XX.__Z�.........__. Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..... _ ....... Ii Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.. .......... Q+' -------•-----••-••--•-••.....:........•-••••--•-•........•-•---....••-••-•----•......••......_............................................................... ODescription of Soil.............................................................................................------•-------------...--------....-------•------•-------••......-•------- x liar .'.............''t... ! 1 W ------•---------------------------------•----------------------------------------------...-------------------------------------...-----------------.....---•-------•--•-------------------•--•••-_...._ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -----•----•-------------------------------------------------------------•--.._..---•-----..........--••-••...------------------------------------------------------------------------.....----•••••-••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of J.— p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of heath. Signed :' r......................................••••-------•--•--------••••----•-_--- ----7.............�.......... ! Date ApplicationApproved By.....--•-••-•--•---•--•--•-•-•----•.....-•--•----•......••---------••......................•-•- Date Application Disapproved for the following reasons:............••-••-•.-•---•--•------------------------------------------------•-------------------------.•---- -•...............................••••----•...---•--•--------•---•----•--•----------------•-••-----------------------------------•---------•----------------------------------------------------•-------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.......................OF...............�t:.a`.:r.'. r. �f..............I....................... �rr�ifirttt�r of f�unt�rlittnr�e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired .•..Y hT" ( ) by......... � 'L. 14�...............•-----------------------._._... .........._........................._........................._........ J Installer at... `�_• fri4/1f �`. s t has been installed in accordance with the provisions of T670 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. ./_ _______________ dated..-.._ -�_r?.Q.. ....._______.. THE ISSUANCE OF THIS"CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �y .......OF...........;� ........................................ lie FEE........................ Disposal Workg Tunutr ion amit Permission is hereby granted...... Xo-�'=_._L ` !l1/-!_ f1 ��.s -•-------•--------------------------------------•-.................._--•--- to Construct (, ) or Repair ( ,') an Individual Sewage Disposal System .............................•-- ••---.............................---••-•. ----• ---•--. •--•...-•-•------------------- --------••-•--••-....... r Street � O w as shown on the application for Disposal Works Construction Per t No. _.__.��.- Dated------({�-------------•--•__-- .......... Alo '`mil ------------- --------•-•-----.-� Board o DATE......... .. • ..................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS L � F.FL. ELEV.= 4.*0 --- FINISH GRADE = GIBS FINISH GRADE FINISH GRADE---- TOP OF FOUND. OVER TANK = _. 5 OVER PIT = 6$}0 ELEV. CHIMNEY BLOCK ",� 4" C.I. 4" V C \ WHERE NEEDED BACKFILL 3 PEAS TONE DWELLING r ul.1�\ 'S4 O r s O O O O O I d d CELLAR FLOOR 60 GALLON -° ' .' �� a ' jo O 0 O o 3/4" TO I-1/2" ELEV. = _5640 REINFORCED GONG. 4 o O O o o ° CRUSHED STONE -- .o o O O7-77 O � op .� t od__ O • o• o O, eY DIST. BOX . � �" ° O o U O o Od � o 0 oa a . O O O o a v � tTO BE LEVEL � Q O ov \l BOTTOM OF PITSEPTIC TANK o Q //AND STABLE) ELEV.7--7 7` = Q SYSTEM PROFILE loll NOT TO SCALE,' I / LEACHING PIT DESIGN CRITERIA NUMBER OF BEDROOMS GALLONS PER DAY =_ __.._____.'S3� ��U --- ( rJ v, �• 1 GARBAGE GRINDER TOTAL DAILY FLOW LEACHING AREA PROVIDED .___—._•-.__�___.:_-_.___ __ �' �� •I a p re t S't � �L� �w Ae_ A � � -7rx4x?.2S e 2 ' C = -455• � *9D � ` y �Z �?N+ A.1c �<A 's n � 1.E4j �Y I �•� •: �rJ � F:k/.) � 1 SOILS LOG f FLAO AL 0" ELEV. = 57+0 u L.4 A.%A I � f SvS4(o PROPOSED SEWAGE DISPOSAL SYSTEM INSPECTED BY'- �..&LI MUP-rZ4� -- _ PROPOSED - DWELLING DATE : � AV �J 37 C .}T( l f ui 1C 1ra�E MASS PERCOLATION RATE .L MIN./INCH SCALE AS NOTED DATE S spr If. f�10 T 4".Si' s1H Of ►a, i t — �r..(�.//�4"'� t a/��'`... G A.� �+� • 51,�,.• �,,:`A,T iJ�rl� 0��" NO�tM11N G�i� �`.. '%t...,�: t•.�f "�14_.1�`�'"4 f f`�.4�'>'+,'�.:��,; • Z- 1_O'r �11C3W!!J CaalC ksJ Tcsq 1 `7HEr<-� �'.)Cr . ., GjtOSSMAN v --127 - --------- 4 - /+„i fit. �' .i 1J S - -— - NORMAN GROSSMAN FE, R.L.S. Fut i vr. �.,�•mV+ = 5 6i�� ai � 226 HOLLY POINT ROAD CENTERVILLE, MASS: �ti